The Tyranny of ‘Public Health’

T he Washington Post ran an op-ed yesterday, “Now’s not the time to dispense with covid-19 precautions,” by two public-health bureaucrats. Lucky Tran, described as “a scientist, public health communicator, and organizer with March for Science and the People’s CDC,” and Oni Blackstock, “a primary-care and HIV physician and founder and executive director of Health Justice,” lambaste “the court order this week lifting mask mandates in transportation settings” as “disastrous.” Masks, the authors argue, keep “essential spaces accessible to all, and they are far more effective when everyone wears one.”

Aside from the dubious scientific basis for the claim (we now have evidence from more than two years of Covid policy to show that mask mandates have little to no effect on Covid infection rates), there’s one particularly telling paragraph in the piece that illustrates the broader defects in the public-health worldview:

Pundits and even the CDC itself are emphasizing that it’s up to individuals to make their own choices about how to protect themselves depending on their risk tolerance. But this narrative goes against the foundation of public health. When a virus capable of serious illness is so widespread and not everyone has equal access to tools to protect themselves, the best way to keep everyone safe is through collective policies.

If the past two and a half years are any indication, the authors are right to argue that the “narrative” of individual liberty “goes against the foundation of public health.” But not in the way that they think: In the Covid era, public-health experts consistently argued for the most extreme, destructive, and draconian restrictions precisely because they monomaniacally viewed the goal of public policy as reducing Covid infection rates at all costs. They recognized no other inputs — mental health, drug addiction, education outcomes, basic constitutional freedoms, and so on — in their evaluation of any given policy.

The adage that “if it saves just one life, it’s worth it” was repeated time and time again throughout the pandemic. But of course, if saving one life at all costs is the singular goal of politics, then no restriction or authoritarian government policy goes too far. That thinking, taken to its logical conclusion, is fundamentally totalitarian. This isn’t hyperbole: The Chinese government, for example — not a regime that is known for its respect for human freedom — has put the “zero Covid” ideology into practice, with devastating results. As we speak, Shanghai’s residents are experiencing exactly what it means in practice. As National Review’s editors wrote last week:

The daytime images of Shanghai streets, emptied of all human life, are a vision of life on earth after a civilization-destroying cataclysm. The nighttime videos, featuring thousands or tens of thousands of people bellowing out from their apartment windows and balconies, crying in desperation for human contact, announcing their fear of running out of food, or simply crying in futile desperation at their inability to attend to their dependent relatives, constitute a horror movie. In some videos, state-controlled drones admonish the people not to sing, or let a cry for freedom dwell in their hearts.

While the checks on government authoritarianism are more robust in traditionally free Western countries, those countries were hardly immune to the zero-Covid thinking that has become conventional wisdom in the transnational public-health bureaucracy. In fact, some Covid hawks in the West openly expressed admiration for China’s Covid response. In November 2021, NPR health reporter Pien Huang, discussing what the U.S. might learn from China’s handling of Covid, remarked ruefully, “I mean, you know, contrast China’s under 200,000 cases with what’s happening here in the U.S., where we’ve had more than 46 million cases.” Under the headline “The world can learn from China’s response to the pandemic, say experts,” the British Medical Journal published a “special collection” of eleven articles expressing admiration for “China’s centrally coordinated national campaign” to contain the virus. In February, the Wall Street Journal ran an article titled “China’s ‘Zero-Covid’ Policy Holds Lessons for Other Nations”: “With each new, more infectious variant, ‘zero Covid’ has required more vigilant and frequent crackdowns on daily activity,” the paper’s chief economics writer argued. “And yet it has lasted. And seen from inside China, the results are remarkable . . . Life in [Beijing] looks close to normal with stores, museums and offices operating and subway and road traffic in line with this time of year in 2019.”

That’s a big “and yet.” The “more vigilant and frequent crackdowns on daily activity” are a necessary feature of the zero-Covid approach; everywhere that policy-makers have been talked into the premise by overzealous public-health experts, devastating restrictions on freedom have followed. The embrace of the China model in countries such as Australia, for example, led to almost unbelievably dystopian transformations, replete with military-enforced curfews, mandatory “quarantine camps,” and even displaced Covid-refugee camps: “Freedom of movement within Australia has been more or less extinguished,” Gideon Rozner wrote for NR in September. “Each state government has — probably unconstitutionally — imposed convoluted entry requirements for interstate visitors, and borders between states are often closed altogether. Entry requirements are sometimes so strict that returning residents cannot even get into their own state, a problem that has recently seen encampments sprout up along the border between Victoria and New South Wales — effectively, Australia now has a class of internally displaced people.”

This is the authoritarianism at the heart of the public-health worldview that has been exposed by the events of the past two years. If it is taken as a universal article of faith that “the best way to keep everyone safe is through collective policies,” as the authors of the Post op-ed argue, it stands to reason that no one should ever be allowed to go outside their house ever again. After all, any number of features of day-to-day life are more dangerous than Covid: Even prior to the vaccine, hospitalization rates for Covid were between 1 and 5 percent. By comparison, as I pointed out in the Spectator in February, bathroom-related injuries have a hospitalization rate of almost 14 percent. The hospitalization rate for lawnmower-related accidents is 11.1 percent. And Americans’ risk of having a heart attack is 2.7 times higher during sex. If it saves one life, it stands to reason that we should ban showers, motorized gardening equipment, and . . . sex.

Car accidents consistently rank among the top causes of death in America. So why not just lower the speed limit to five miles per hour — or better yet, close the highways, ban cars, and revert back to the horse and buggy? Well, mostly because that would be insane. Politics is about assessing trade-offs; men are not angels, and angels do not govern men. In our fallen world, there is no policy that does not come with a corresponding cost. The great lie of the progressive desire for rule via “the experts” is that no amount of scientific information or expertise can actually tell us how to navigate and weigh these varying considerations. That’s what politics, properly understood, is for. But if Covid has taught us anything, it’s that many of our leading experts — blinded as they are by their singular focus, unwilling to acknowledge even the existence of trade-offs — are unable to see the bigger picture.